Identifying Complementary and Alternative Medicine Usage Information from Internet Resources. A Systematic Review

A model of purchase intention of complementary and alternative medicines: the role of social media influencers' endorsements

BACKGROUND

Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers' purchase intention of CAMs.

METHODS

This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model.

RESULTS

This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers' preferences to purchase CAMs by taking into consideration SMIs' endorsements.

CONCLUSIONS

This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI's on the use of CAMs, as well as to regulate the content of these promotional materials.

What are the ways in which social media is used in the context of complementary and alternative medicine in the health and medical scholarly literature? a scoping review

BACKGROUND

Despite the increased use of social media to share health-related information and the substantial impact that complementary and alternative medicine (CAM) can have on individuals' health and wellbeing, currently, to our knowledge, there is no review that compiles research on how social media is used in the context of CAM. The objective of this study was to summarize what are the ways in which social media is used in the context of CAM.

METHODS

A scoping review was conducted, following Arksey and O'Malley's five-stage methodological framework. MEDLINE, EMBASE, PsycINFO, AMED, and CINAHL databases were systematically searched from inception until October 3, 2020, in addition to the Canadian Agency for Drugs and Technology in Health (CADTH) website. Eligible studies had to have investigated how at least one social media platform is used in the context of a single or multiple types of CAM treatments.

RESULTS

Searches retrieved 1714 items following deduplication, of which 1687 titles and abstracts were eliminated, leaving 94 full-text articles to be considered. Of those, 65 were not eligible, leaving a total of 29 articles eligible for review. Three themes emerged from our analysis: 1) social media is used to share user/practitioner beliefs, attitudes, and experiences about CAM, 2) social media acts as a vehicle for the spread of misinformation about CAM, and 3) there are unique challenges with social media research in the context of CAM.

CONCLUSIONS

In addition to social media being a useful tool to share user/practitioner beliefs, attitudes, and experiences about CAM, it has shown to be accessible, effective, and a viable option in delivering CAM therapies and information. Social media has also been shown to spread a large amount of misleading and false information in the context of CAM. Additionally, this review highlights the challenges with conducting social media research in the context of CAM, particularly in collecting a representative sample.

Complementary and Integrative Medicine: Origins and Expanding Horizons

This article is an introduction to the concepts of complementary, alternative, and integrative medicine. It discusses the scope and prevalence of complementary and integrative medicine (CIM) use among otolaryngology patients. Specific types of CIM are characterized in the context of their origins, philosophic and historical bases, scientific evidence, and applicability to the practice of otolaryngology. The author's intent is to provide a framework for discussing CIM with patients and integrate into treatment paradigms in an evidence-based manner.

Safety and use of complementary and alternative medicine in Norway during the first wave of the COVID-19 pandemic using an adapted version of the I-CAM-Q; a cross-sectional survey

Background

The COVID-19 pandemic lockdown has had a profound impact on physical and mental well-being throughout the world. Previous studies have revealed that complementary and alternative medicine (CAM) is frequently used for, and can be potential beneficial for strengthening physical mental resilience. The aims of this study were therefore to determine the prevalence and reasons for use of CAM during the first wave of the COVID-19 pandemic among a representative sample of the Norwegian population, and further determine self-reported effects and adverse effects of the CAM modalities used.

Methods

Computer assisted telephone interviews using a COVID-adapted I-CAM-Q questionnaire were conducted with 1008 randomly selected Norwegians aged 16 and above using multistage sampling during April and May 2020 applying age and sex quotas for each area. Frequencies, Pearson’s chi-square tests, Fisher exact tests, and independent sample t-test were used to identify the users of CAM, what they used, why they used it and whether they experienced effect and/or adverse effects of the modalities used, and further to describe differences in sociodemographic factors associated with CAM use. Cronbach's alpha tests were used to test for internal consistency in the different groups of CAM. Significance level was set to p < 0.05.

Results

The study revealed that two thirds of the respondents (67%) had used CAM within the first 3 months of the COVID-19 pandemic, in particular CAM modalities that did not involve a provider. Most used were natural remedies and dietary supplement (57%, mainly vitamins and minerals), but self-help practices like yoga and meditation were also widely used (24%). Women used CAM modalities significantly more than men (77% vs. 58%). Most of the respondents found the modalities they used beneficial, and few reported adverse effects of the treatments.

Conclusions

A large proportion of the Norwegian population used CAM during the first wave of the COVID-19 pandemic with high satisfaction and few reported adverse effects. CAM was rarely used to prevent or treat COVID-19, but rather to treat a long-term health condition, and to improve well-being.

Spontaneously generated online patient experience data - how and why is it being used in health research: an umbrella scoping review

PURPOSE

Social media has led to fundamental changes in the way that people look for and share health related information. There is increasing interest in using this spontaneously generated patient experience data as a data source for health research. The aim was to summarise the state of the art regarding how and why SGOPE data has been used in health research. We determined the sites and platforms used as data sources, the purposes of the studies, the tools and methods being used, and any identified research gaps.

METHODS

A scoping umbrella review was conducted looking at review papers from 2015 to Jan 2021 that studied the use of SGOPE data for health research. Using keyword searches we identified 1759 papers from which we included 58 relevant studies in our review.

RESULTS

Data was used from many individual general or health specific platforms, although Twitter was the most widely used data source. The most frequent purposes were surveillance based, tracking infectious disease, adverse event identification and mental health triaging. Despite the developments in machine learning the reviews included lots of small qualitative studies. Most NLP used supervised methods for sentiment analysis and classification. Very early days, methods need development. Methods not being explained. Disciplinary differences - accuracy tweaks vs application. There is little evidence of any work that either compares the results in both methods on the same data set or brings the ideas together.

CONCLUSION

Tools, methods, and techniques are still at an early stage of development, but strong consensus exists that this data source will become very important to patient centred health research.

Tracking discussions of complementary, alternative, and integrative medicine in the context of the COVID-19 pandemic: a month-by-month sentiment analysis of Twitter data

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the paucity of evidence, various complementary, alternative and integrative medicines (CAIMs) have been being touted as both preventative and curative. We conducted sentiment and emotion analysis with the intent of understanding CAIM content related to COVID-19 being generated on Twitter across 9 months.

METHODS

Tweets relating to CAIM and COVID-19 were extracted from the George Washington University Libraries Dataverse Coronavirus tweets dataset from March 03 to November 30, 2020. We trained and tested a machine learning classifier using a large, pre-labelled Twitter dataset, which was applied to predict the sentiment of each CAIM-related tweet, and we used a natural language processing package to identify the emotions based on the words contained in the tweets.

RESULTS

Our dataset included 28 713 English-language Tweets. The number of CAIM-related tweets during the study period peaked in May 2020, then dropped off sharply over the subsequent three months; the fewest CAIM-related tweets were collected during August 2020 and remained low for the remainder of the collection period. Most tweets (n = 15 612, 54%) were classified as positive, 31% were neutral (n = 8803) and 15% were classified as negative (n = 4298). The most frequent emotions expressed across tweets were trust, followed by fear, while surprise and disgust were the least frequent. Though volume of tweets decreased over the 9 months of the study, the expressed sentiments and emotions remained constant.

CONCLUSION

The results of this sentiment analysis enabled us to establish key CAIMs being discussed at the intersection of COVID-19 across a 9-month period on Twitter. Overall, the majority of our subset of tweets were positive, as were the emotions associated with the words found within them. This may be interpreted as public support for CAIM, however, further qualitative investigation is warranted. Such future directions may be used to combat misinformation and improve public health strategies surrounding the use of social media information.

Quality of complementary and alternative medicine information for type 2 diabetes: a cross-sectional survey and quality assessment of websites

BACKGROUND

The global prevalence of diabetes mellitus is projected to reach approximately 700 million by the year 2045, with roughly 90-95% of all diabetes cases being type 2 in nature. Patients with type 2 diabetes mellitus (T2DM) frequently seek information about complementary and alternative medicine (CAM) online. This study assessed the quality of publicly accessible websites providing consumer health information at the intersection of T2DM and CAM.

METHODS

An online search engine (Google) was searched to identify pertinent websites containing information specific to CAM for T2DM patients, and the relevant websites were then screened with an eligibility criteria. Consumer health information found on eligible websites were then assessed for quality using the DISCERN instrument, a 16-item standardized scoring system.

RESULTS

Across the 480 webpages identified, 94 unique webpages remained following deduplication, and 37 eligible webpages belonged to and were collapsed into 30 unique websites that were each assessed using the DISCERN instrument. The mean overall quality score (question 16) across all 30 assessed websites was 3.55 (SD = 0.86), and the mean summed DISCERN score was 52.40 (SD = 12.11). Eighty percent of websites presented a wide range of CAM treatment options with the associated benefits/risks of each treatment, but in 56.7% of the websites, the sources used to collect information were unreliable.

CONCLUSION

This study identified, assessed, and presents findings on the quality of online CAM information for T2DM. Although there were several high scoring websites, there was variability across most of the individual DISCERN items in the assessed websites. This study highlights the importance of awareness among healthcare providers regarding the reliability of online information about CAM treatment and management options for T2DM. Healthcare providers should be aware of patients' information seeking behaviour, guide them in navigating through the content they encounter online, and provide them with resources containing trustworthy and reliable information.

Global prevalence and types of complementary and alternative medicines use amongst adults with diabetes: systematic review and meta-analysis

AIM

This study aimed to undertake a systematic review and meta-analysis of global prevalence and types of complementary and alternative medicine (CAM) use amongst adults with diabetes.

METHODS

Nine databases, including MEDLINE and EMBASE, were searched for studies published between 2009 and 2019 which included extractable data for CAM use in adult patients with diabetes. Study characteristics, types of CAM, and overall and subgroup prevalence data in relation to CAM use were extracted. Meta-analysis of aggregate level data on prevalence and prevalence ratios (PRs) was performed using a random effects model.

RESULTS

From the 38 studies included in the review, a total of 37 types of CAM and 223 types of herbs were identified. Pooled prevalence of CAM use was 51%. A wide variation in prevalence rates (predictive interval 8-93%) was observed. In the context of high heterogeneity, we found no evidence that CAM use was associated with gender, chronicity or type of diabetes. Approximately one third of patients did not disclose their use of CAM to healthcare professionals (95% PrI 25%, 97%). Herbal medicines, acupuncture, homoeopathy and spiritual healing were the common CAM types reported.

CONCLUSIONS

A wide variation in prevalence of CAM use by patients with diabetes was identified. Healthcare professionals should be aware of their patients' use of CAM to ensure treatment optimization, avoid herb-drug interactions and promote medication adherence in diabetes. Diabetic reviews and clinical guidelines should incorporate exploration of patient use of CAM as many patients do not proactively disclose the use of CAM to their healthcare professionals.

REGISTRATION

The protocol for this study was registered with the Centre for Review and Dissemination (CRD). Protocol registration number CRD42019125036.

Evaluation of China's public health system response to COVID-19

Background

The focus of the study is to assess the advantages and shortcomings of China's public health system in the process of the COVID-19 prevention and to discuss the future reform of China's public health system.

Methods

By searching literature and reports related to the COVID-19 prevention of China, we compared the prevention effectiveness with the prevention policies in the process of the COVID-19 prevention.

Results

China's public health system can effectively combine national power to maximize the effectiveness of pandemic prevention. It improved the pandemic prevention ability of communities continuously and promoted the fairness of prevention. Traditional Chinese Medicine has also been used in pandemic prevention, which reduces the drug resistance of the virus. At the same time, the combination of the disease diagnosis and the Internet has reduced the spread speed of the pandemic. China's public health system also has some problems in response to the COVID-19, such as the shortage of medical resources, insufficient alerts, the low efficiency of reporting to superior government and the shortage of reward and punishment system for pandemic prevention.

Conclusions

China's practice and efforts of the COVID-19 prevention can provide experience for other countries to improve their public health systems and accelerate the end of the COVID-19 pandemic.

Characteristics of Websites Presenting Parenteral Supplementation Services in Five European Countries: A Cross-Sectional Study

We aimed to characterize the parenteral supplementation services in Czechia, Ireland, Italy, Poland, and the United Kingdom based on their websites. We generated a list of websites by searching Google using the term “vitamin infusion” and selected cities with 250,000 citizens from each analyzed country. All search inputs were performed using the native language. Data on the features of services, indications, contraindications, offered parenteral supplements, and social media activity were obtained. We analyzed 317 websites representing 371 active facilities. Only 6 (1.9%) facilities cited the scientific sources on parenteral supplementation, but these reference were highly biased; 17.4% did not provide information regarding their personnel, while 11.9% indicated the different contraindications. The most common indications were fatigue (62.5%), immunity enhancement (58.0%), anti-aging, and physical activity (51.5%). Approximately, 11.6% of facilities claimed that some parenteral supplements can help manage certain malignancies, while 2.2% claimed that they can help manage fertility problems. The most offered intravenous supplements were vitamins C (57.4%), B12 (47.7%), and B6 (42.3%). The parenteral supplementation market offers numerous ingredients as treatment for general health problems and serious health conditions. Many analyzed websites lacked essential information, which creates concerns for regarding the quality and reliability of the services.

In the Turkish News: Coronavirus and "Alternative & complementary" medicine methods

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Recommendations and advice have increase.

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There were very little information about the effect of CAM.

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There weren’t any scientific articles.

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There was a serious increase in the number of news.

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The content and sources of the news were insufficient.

Background and Object

The object of this study is to analyze the complementary and alternative treatments for the prevention of COVID-19/Coronavirus in the Turkish news.

Material and Method

The sample of this descriptive study consisted of 160 news articles published between 11 March and 11 April 2020 on the websites of the three highest-circulating newspapers throughout the nation. A quantitative media context analysis method, consisting of 14 questions and 2 sections was employed to evaluate news on the newspapers. The data was analyzed using SPSS 21.0 statistical package program using numbers and percentages.

Results

Forty percent of the news analyzed within the scope of the study were obtained from the newspaper’s own news, reporter or columnist, 56.9 % were informative, 6.3 % were advisory and critical against the CAT methods. 95 % of the news included preventive or protective methods against COVID-19. 77.5 % of the complementary and alternative medicine methods mentioned in the news were biologically-based, 20.6 % were mind-body practices. It was determined that 85.0 % of the benefits, harm and side effects of the methods mentioned in the news were announced, but their impact on COVID-19 is not clarified (78.1 %), and there was insufficient information provided about the method and dosage of the method. It was seen that all news contained information on protection against COVID-19 or prevention of COVID19.

Conclusion

It was concluded that the sources and methods and the number of news items changed from one newspaper to another, the news lacked a scientific basis, and as a result, it might lead to misinterpretations among the public. There were different opinions among the experts in the proposed or criticized complementary and alternative medicine methods. It was observed that there was an increase in the number of news items related to using complementary and alternative medicine methods for the treatment of COVID19, a clear and easily understandable language was used in the news, but the content and sources of the news were insufficient in conveying the correct and scientific information. It was reported by previous literature potential interactions between herbal remedies/dietary supplements and prescribed drugs, complications of medical conditions and some adverse effects cause of CAM usage

Is non-traditional therapy for multiple sclerosis overwhelming in Saudi Arabia

Objectives:

To describe the prevalence, knowledge and attitudes about complementary and alternative medicine (CAM) use and the proportion that seek advice from their physician about CAM use.

Methods:

This cross-sectional observational study was performed in multiple sclerosis (MS) clinic of King Fahd Hospital of Universityin Alkhobar, Kingdom of Saudi Arabia from January-June 2017. A total of 133 patients have completed the survey.

Results:

The mean age of patients was 32.3±7.6 years and 84 (63.2 %) were female. Approximately 83.5% of the patients reported the use of CAM. Among all the reported forms of CAM, vitamins were the most prevalent form, followed by cupping, special prayers and meditation. The majority of patients (62%) obtained knowledge of CAM through social media. A significant number of patients (75.6%) did not disclose the use of CAM to their physician. There was a trend for using CAM more in highly educated, older age, and female patients. The most commonly reported rationale to use CAM was overall improvement in health status.

Conclusion:

The use of CAM among Saudi patients with MS is highly prevalent, without disclosure of its use to physicians. These factors should be taken into account in the doctor-patient consultation to avoid adverse events.

Identifying Supplement Use Within Clinical Notes: An Applicationof Natural Language Processing

Recent statistics indicate that the use of dietary supplements has increased over the years. Although being popular among consumers who use them for a variety of reasons, there have been limited clinical data-driven studies of the impact of dietary supplements on health outcomes. Challenges that impede such analyses in a comprehensive manner include either the sequestered nature of such data or their embedding within biomedical and clinical text. This study explored the feasibility to uncover patterns in the use of supplements, focusing on vitamin use among patients diagnosed with mental illness within patient records from the MIMIC-III database. The relevance of vitamin(s) was calculated at different levels of granularity and compared with association identified from Dietary Supplement Subset of MEDLINE. The results reveal insights into vitamin use for specific mental health related diagnosis and highlight challenges with identifying supplement information from clinical sources.